Factors affecting insufficiency in activity daily living in the elderly

In a "case-control" study we investigated the correlations among twenty-four clinical signs of "functional impairment" and probability of "activity daily living insufficiency".

The study involved 788 randomised inpatients, aged 65 years and over, of nineteen long-stay hospitals of an Italian region (Lazio, Rome). We measured self care autonomy, mobility and continence, on a modified Barthel's scale; the score on Barthel's scale, Barthel Index (BI), was correlated to twenty-four signs of "functional impairment" (explicative variables). Of these variables entered in stepwise regression only "cognitive impairment" (coef. B-22), "paralysis" (coef. B-21), "body weight reduction over 10 kg vs ideal weight" (coef. B-12), "joint deformation" (coef. B-7) and "visual impairment" (coef. B-5). Insufficiency in daily living is defined by BI < 100. The presence of these five clinical signs leads to the likelihood of "activity daily living insufficiency" to 0.996. The trend of cognitive impairment to rise with age could be responsible for the inverse regression between age and BI.

There was no significant correlation between BI and sex. Hearing impairment, serum creatinine level > or = 4 mg/dl, bronchospasm, obstructive and restrictive ventilation disorders, precordial pain on stress or spontaneous and dyspnea are not significantly correlated to the Barthel Index Score and to the likelihood of insufficiency in daily living activity.